VIRGINIA DEPARTMENT OF SOCIAL SERVICES

The Crossings at Ironbridge
6701 Ironbridge Parkway
Chester, VA 23831
(804) 748-7000

Current Inspector: Kimberly Davis (804) 662-7578

Inspection Date: March 12, 2024

Complaint Related: Yes

Areas Reviewed:

22VAC40-73 RESIDENT CARE AND RELATED SERVICES

Comments:

Type of inspection: Complaint Date(s) of inspection and time the licensing inspector was on-site at the facility for each day of the inspection: 3-12-24 from 10:02 a.m.-2:25 p.m. The Acknowledgement of Inspection form was signed and left at the facility for each date of the inspection. A complaint was received by VDSS Division of Licensing on 2-14-24 regarding allegations in the area(s) of: resident care and related services. Number of residents present at the facility at the beginning of the inspection: 66 Number of resident records reviewed: 1 Number of interviews conducted with staff: 1 An exit meeting was conducted to review the inspection findings. The evidence gathered during the investigation supported the allegation(s) of non-compliance with standard(s) or law, and violation(s) were issued. Any violation(s) not related to the complaint but identified during the course of the investigation can also be found on the violation notice. The licensee has the opportunity to submit a plan of correction to indicate how the cited violation(s) will be addressed in order to return the facility to compliance and maintain future compliance with applicable standard(s) or law. If the licensee wishes to provide a plan of correction: (i) type the plan on a separate Word document, (ii) identify the standard violation number being addressed, (iii) include the date the violation will be corrected, (IV) do not include any names or confidential information, and (V) return to the licensing inspector by email within five (5) business days of the exit interview. Compliance with all applicable regulations and law shall be maintained and any areas of noncompliance must be corrected. Within 15 calendar days of your receipt of the inspection findings (inspection summary, violation notice, and supplemental information), you may request a review and discussion of these findings with the inspector's immediate supervisor. To make a request for review and discussion, you must contact the licensing supervisor at the regional licensing office that serves your geographical area. Regardless of whether a supervisory review has been requested, the results of the inspection will be posted to the DSS public website within 5 business days of your receipt of the Inspection Summary and/ or Violation Notice. The department's inspection findings are subject to public disclosure. Please Note: A copy of the findings of the most recent inspection are required to be posted on the premises of the facility. For more information about the VDSS Licensing Programs, please visit: www.dss.virginia.gov Should you have any questions, please contact Kimberly Davis, Licensing Inspector at (804) 662-7578 or by email at Kimberly.M.Davis@dss.virginia.gov

Violations:

Standard #:	22VAC40-73-460-H
Complaint related:	Yes
Description:	Based on a review of the facility?s shower log for Resident # 1, the facility failed to ensure that personal assistance and care are provided to each resident as necessary so that the needs of the resident are met, including assistance or care with: Bathing- at least twice a week, but more often if needed or desired and hygiene and grooming to include skin care at least twice daily for those with limited mobility. Evidence: -The facility?s shower log for January and February 2024 for Resident # 1 indicated that the resident only received a shower or bath on 1-1-24, 1-8-24, 1-15-24, and 1-29-24, 2-5-24, and 2-14-24. The shower log indicates that the resident refused a shower/bath on 1-10-24, 1-17-24, 1-22-24, and 2-7-24. -The facility?s Skin Integrity Monitoring sheet for February 2024 for Resident # 1 only indicated skin care monitoring on 2-5-24, 2-7-24, 2-12-24, and 2-14-24.
Plan of Correction:	Effective immediately, at least 1x per week, HCD/HSD or designee shall review the daily shower sheets to ensure all residents are receiving showers per his/her care plan/at least 2x weekly. In the event that a resident refuses, two additional attempts shall be made on the same day to offer a shower. If the resident continues to refuse, it will be documented on the shower sheet and another attempt will be made on the following day. Responsible Party to be notified of refusal and documented. Any alteration of the number of weekly showers are requested by the resident or his/her legal guardian, such request shall be indicated on the resident?s ISP/Care Plan.
Standard #:	22VAC40-73-460-I
Complaint related:	Yes
Description:	Based on a review of the resident?s record the facility failed to ensure that each resident shall be dressed in clean clothing and be free of odors related to hygiene. Evidence: -Hospice documentation for Resident # 1 dated 2-12-24 noted, ?He is noted to be unkempt with food on shirt, face, and wheelchair.? -Hospice documentation dated 2-14-24 noted, ?changed clothing and provided nail care as patient was disheveled and malodorous.?
Plan of Correction:	Effective immediately, HCD/HSD or designee to in-service all care staff on harmony policy and procedures on providing basic care to residents in the community.
Standard #:	22VAC40-73-680-D
Complaint related:	Yes
Description:	Based on a review of the resident?s record the facility failed to ensure that medications shall be administered in accordance with the physician's or other prescriber?s instructions. Evidence: The physician?s order for Resident # 1 dated 2-1-24 noted ?D/C Metoprolol Succ 50 mg?. However, the resident?s Medication Administration Record (MAR) for February 2024 indicates that the facility continued to administer Metoprolol Succ 50 mg to the resident on February 2,3,7,10,11,12,13, and indicated D/C on 2-16-24.
Plan of Correction:	HCD or designee will continue weekly med cart checks to ensure removal of all discontinued medications. ALL RMA?s or nurses to be in serviced to remove all discontinued medication upon receipt of orders from physician.